Date of death
Item
1. Date of death
date
Time of death
Item
1. Time of death
time
Item
2. Cause of Death
integer
Code List
2. Cause of Death
CL Item
Pulmonary embolism (1)
CL Item
Peripheral arterial disease (46)
Item
If cardiovascular, select one
integer
Code List
If cardiovascular, select one
CL Item
Cardiovascular death - CHD (77)
CL Item
Cardiovascular death - Non-CHD (78)
CL Item
Non-cardiovascular death (32)
Item
If sudden death, select one
text
Code List
If sudden death, select one
CL Item
Sudden death (76)
CL Item
Arrhythmia (ventricular fibrillation or other lethal arrhythmias without known secondary cause) (48)
CL Item
Congestive heart failure/shock (49)
CL Item
Death of unknown origin (33)
Item
If other vascular cause of death, select one
text
Code List
If other vascular cause of death, select one
CL Item
Pulmonary embolism (1)
CL Item
Peripheral arterial disease (46)
other vascular cause of death specification
Item
If other "other vascular cause of death", specify
text
autopsy
Item
3. Was autopsy performed?
boolean
narrative autopsy
Item
4. Provide narrative
text
Date documents sent to CEC Document Group
Item
5. Date documents sent to CEC Document Group
date
Item
6. Adjudication
integer
Code List
6. Adjudication
CL Item
Cardiovascular death - CHD (77)
CL Item
Cardiovascular death - Non-CHD (78)
CL Item
Non-cardiovascular death (32)
Item
If cardiovascular death - CHD, select one
text
Code List
If cardiovascular death - CHD, select one
CL Item
Sudden death (76)
CL Item
Arrhythmia (ventricular fibrillation or other lethal arrhythmias without known secondary cause) (48)
CL Item
Congestive heart failure/shock (49)
CL Item
Death of unknown origin (33)
Item
If sudden death, select one
integer
Code List
If sudden death, select one
other cardiovascular death - CHD specification
Item
If other cardiovascular death - CHD, specify
text
Item
If death of unknown origin, select one
integer
Code List
If death of unknown origin, select one
CL Item
Limited or no source documents (56)
CL Item
Adequate source documents to make the call for an Unknown death (57)
Item
If cardiovascular death - Non-CHD, select one
integer
Code List
If cardiovascular death - Non-CHD, select one
CL Item
Other vascular causes of death (51)
CL Item
Fatal stroke (45)
CL Item
Complication of a cardiovascular procedure (47)
Item
If other vascular cause of death, select one
text
Code List
If other vascular cause of death, select one
CL Item
Pulmonary embolism (1)
CL Item
Peripheral arterial disease (46)
other vascular cause of death specification adjudication
Item
If other "other vascular cause of death", specify
text
Item
If non-cardiovascular death, select one
text
Code List
If non-cardiovascular death, select one
CL Item
Neoplasm/cancer (59)
CL Item
Infection/sepsis (60)
CL Item
Post non-cardiovascular surgery (53)
other non-cardiovascular death specification
Item
If other non-cardiovascular death, specify
text
Item
7. Was this event related to a stent thrombosis?
text
Code List
7. Was this event related to a stent thrombosis?
Date of adjudication
Item
8. Date of adjudication
date
Trigger number
Item
9. Trigger number
text
Item
10. CEC Status
integer
CL Item
Coordinator Screen check (2)
CL Item
Ready for review (4)
CL Item
In Phase I review (5)
CL Item
Queried (InForm) (6)
CL Item
Additional documents required (7)
CL Item
In Phase II committee (8)
CL Item
Completed event (11)
CL Item
No event to adjudicate (12)
CL Item
QC Random sample (13)
CL Item
In Translation (14)
Date of status change
Item
11. Date of status change
date
Item
12. Physician review #1: Physician
integer
Code List
12. Physician review #1: Physician
Physician review 1 Date sent to reviewer
Item
12. Physician review #1: Date sent to reviewer
date
Physician review 1 Date received from reviewer
Item
12. Physician review #1: Date received from reviewer
date
Item
12. Physician review #2: Physician
integer
Code List
12. Physician review #2: Physician
Physician review 2 Date sent to reviewer
Item
12. Physician review #2: Date sent to reviewer
date
Physician review 2 Date received from reviewer
Item
12. Physician review #2: Date received from reviewer
date
CEC Coordinator comments
Item
14. CEC Coordinator comments
text
CV event number
Item
15. CV event number
text
Adverse event reference identifier
Item
16. Adverse event reference identifier
text
Adverse event term
Item
17. Adverse event term
text